Staten Island's doctors say a new study pointing up a huge disparity in access to health care bolsters their contention that the borough needs and deserves a public hospital.

The report, commissioned by the Richmond County Medical Society and paid for by the Staten Island Foundation, was released last night at the Staten Island Hotel, Graniteville.

"The major problem does not appear to be hospital care," said one of the study's authors, Dr. Daniel Weisz of the International Longevity Center. "There are no simple answers. ... There are sections [of the population] that smoke too much, that are obese, and there are sections that are impoverished."

The study did not identify specific fixes for a system that many perceive as broken and blame for the borough's having the second-highest death rate in the city, just behind the Bronx.

Rather, it dealt in generalities, recommending more clinical and diagnostic services for distressed neighborhoods like Port Richmond and St. George and yet more programs to help Islanders lose weight and quit smoking.

"You see it and say, 'Poor people get poorer care, do we really need a study for that?'" said Dr. Janet Norton, a Castleton Corners surgeon. "Before you say that, [the study] is a start."

The medical society, which counts 1,058 Island physicians as its members, said the report's discovery of vast disparities in access to care between the poorer North Shore and more affluent parts of the Island shows the city Health and Hospitals Corporation needs to do more.

"I think it's overly simplistic to say we smoke too much and we eat too much, and that's why we're dying at the same rate as the Bronx," said the medical society's president, Dr. Allan Perel. "We need the same things [from HHC] the other boroughs get."

Dr. Perel called on the HHC to provide the same services that one would find there, like prescription benefits, a rape clinic and ready access to diagnostic services.

But the HHC, which maintains 11 public hospitals, all in the other four boroughs, claimed vindication last night for its stand that the Island doesn't necessarily need a public hospital.
LaRay Brown, HHC senior vice president, said the study "confirms many of the things we've been saying for years."

It was Ms. Brown who came under fire last fall for maintaining that the city doesn't benefit by not having to pay for an HHC hospital in the borough. "In reality, you're not saving the city anything. ... There's no big check that comes to HHC."

Last night, she insisted that the agency is committed to improved services for the borough.

While the study found it "unlikely that the health problems ... are primarily the result of poor access to hospital care," it noted that residents of poorer communities are much less likely to see a doctor in time to avert fatal diseases, and in particular are less likely to receive coronary bypass or angioplasty operations following heart attacks.

State Assemblyman Matthew Titone (D-North Shore) ridiculed the HHC's new "mobile medical unit" as a poor substitute for clinics; Ms. Brown called the clinics an imperfect solution, but a strategy that works elsewhere in the city.

Assemblyman Lou Tobacco (R-South Shore), also attended last night's conference. He is on record as saying that the Island's relation to HHC is tantamount to "taxation without representation."

The Island had 825 deaths per 100,000 residents in 2004, while the Bronx had 833. Citywide, the rate was 707 deaths per 100,000. The borough's death rates from cancer is 25 percent higher than the city average; pneumonia is 75 percent greater, and fatal chronic lung disease here outstrips the city average by 65 percent.

The Island is the most affluent of the five boroughs and one of the best educated, yet leads the city in deaths from cancer, chronic lung disease, influenza and pneumonia and heart disease. Coincidentally, its residents are more obese and more likely to smoke.

"There's a health problem on Staten Island," said the study's co-author, New York University professor Victor Rodwin. "It needs an integrated response. The response is not just one more public hospital or another billion dollars."

The crowd of about 100 health-care professionals, doctors and hospital administrators applauded the report, but said the data is merely the first step toward real fixes.